The most frequently asked EMDR Supervision questions – Part 3
Before COVID 19 I was writing a 5 part blog series looking at the questions that were asked the most in EMDR supervision. For the past 6 weeks, I have talked in my blog about the challenges and the gains in moving all our work online.
Over the last week or so I have noticed as we adjust to the current situation and it becomes the new norm, there have been less questions in supervision about doing EMDR online. I was 2 episodes in and had looked at the questions Who should I start working with?(https://theemdrsupervisor.com/the-most-frequently-asked-emdr-supervision-questions-part-1/) And then part 2 looked at The safe place isn’t working what should I do? (https://theemdrsupervisor.com/the-most-frequently-asked-emdr-supervision-questions-part-2/).
The next most popular supervision question is about Phase 3 Assessment, and in particular supervisees struggling to get the right cognitions.
As new EMDR therapists we can get pulled into trying to do a perfect assessment phase. What I notice when I’m trying too hard to get something right I lose the connection with my client, I over think and get stuck down a rabbit hole! Does this sound familiar? One of the most useful tips is to record myself and watch it back. I easily pick up the mistakes I make and notice how I could have made the process much more efficient.
I recall a few years ago I recorded a session of me doing a Phase 3 assessment, when I watched it back I noticed that I spent way too long on the cognitions. I must have been a bit more anxious as I was recording myself because the client told me the cognition straight away and despite me listening attentively (or so I thought), I didn’t hear what she said.
The key things we need to remember is that the cognitions need to be self referencing, false and for a better treatment effect generalisable. Sometimes we can get in a pickle trying to remember all these things but with practice and time it does become easier. That’s one of the reasons why I always recommend starting simple with EMDR as this gives you the chance to work with more memories.
There is no harm in having your cognition list with you and showing it to the client if you do get stuck but again don’t spend too much time on this, it does not have to be perfect! It helps if we can remember the purpose of our Phase 3 Assessment, to activate the trauma memory so we can move onto our phase 4 and start desensitising the memory as soon as possible. It’s like being at the top of a diving board, once we have assessed the logistics of the dive, we don’t stay up there forever, we just need to dive in!
I also think it’s ok to make a suggestion to the client if they are struggling to identify a cognition. As we listen to the stories that client’s tell us about the trauma they have experienced, you can often pick out the self referencing statements they make. It really helps me to think about the domains of the cognitions Responsibility, Safety, Self defectiveness and Control. I might say to a client ‘It’s my fault, does that fit?’ for example and most clients will let you know if your suggestion has not connected.
We want to open up the neural networks where the memory and the negative beliefs are stored. Remember that once we have activated the trauma memory we don’t tend to go back to the cognitions until processing is finished.
I also have found that the cognition we identify in the assessment phase are not the only cognitions that get activated and worked through in the Phase 4 desensitisation phase. In my experience therapy involves peeling back the layers so once we have worked through one cognition, a different theme in the processing tends to be worked through too.